Anxiety and Food Allergies

When parents learn of their child’s food allergy, it is common to feel overwhelmed, frightened and even depressed. As with many things in life, knowledge and experience ease the initial fright. With time, parents are empowered and feel they have learned how to handle their child’s allergy. As children grow, a new challenge often develops. Families start managing not only their child’s food allergy, but also his anxiety over his food allergy.

It is important to say that some level of apprehension is expected. In fact, some level of worry is necessary to remain vigilant about avoiding an allergic trigger. However, the line between appropriate precautions and excessive anxiety can sometimes get murky. I would like to focus on anxiety that may limit daily activities, cause social isolation or result in unnecessary medical interventions. For example, a child may refuse to play with someone out of fear. Another child may be hesitant to eat a new food even after confirming it is safe. Still another child may experience a panic attack which results in epinephrine treatment and a visit to the ED.

What can a parent do if they feel their child is beginning to develop some of these signs?

1. Validate your child’s feeling. Please don’t dismiss their feelings as silly or trivial. Don’t minimize what they are experiencing by saying “it’s just anxiety”. What your child is feeling is very real and very scary for them. She is looking to you for nonjudgmental support.

2. Knowledge is power. Try to explain to your child (in an age appropriate way), how an allergic reaction occurs. An anaphylactic reaction from inhaling or contacting an allergen is extremely rare, yet many people live their life plagued by this fear. Let your child know that he is safe when his friends wash their hands and that he is safe even if someone in the classroom is eating a potential allergen. Explain the difference between anxiety and an allergic reaction.

3. Encourage your child to keep a “worry diary”. You can review this diary with your child and differentiate current worries from hypothetical worries. For the current worries, you can try to problem solve solutions. A hypothetical worry is a worry about something that may not happen. For these worries, you can try to teach your child relaxation techniques. You can also practice thought challenges, which is a way to gently encourage your child to dismantle unrealistic fears. Finally, you should try to equip your child with positive self-messages to handle some of his worries.

4. Arm your child with relaxation techniques, such as listening to calm music, reading a book, or using visual imagery. Deep breathing is one of the best relaxation techniques to help distract a child and ultimately calm him down.

5. Encourage your child to participate in her usual activities without letting her food allergies dictate her activities. Again, be careful you do this without belittling her fears.

6. Manage your own anxiety. Children are very perceptive and if they sense you are scared, that fear will be transferred to them. Part of this is allowing them to be around their allergen from a young age so they can learn how to function, even with a peanut in the room.

7. Recognize signs that your child needs more help. If the above techniques don’t work, I would consider having your child see a psychologist to learn techniques of cognitive behavioral therapy to manage his anxiety. There are some psychologists who specialize in food allergy anxiety but any medical psychologist will be able to help kids cope with a chronic medical illness, such as food allergies.

Linda Herbert, a clinical psychologist who specializes in food allergy, says her goal is to “help families incorporate food allergies into their life without making food allergies become their ENTIRE life.” My goal as a physician is similar. I want to keep your child safe, without letting their food allergy hold them back. If your child needs to go to the nurse’s office every day because of his food allergy, I am not doing my job.

To learn more about handling food allergies, listen to our PediaCast episode with Dr. Mike Patrick.

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Dr. Irene MikhailDr. Irene Mikhail is a member of the Section of Allergy and Immunology at Nationwide Children’s Hospital. Prior to joining Nationwide, she worked at Children’s National Medical Center in Washington DC and the National Institutes of Health in Bethesda, MD. She loves improving the quality of life and safety for children with allergies, asthma and eczema. However, she has a particular interest in treating children with food allergies and performing research to increase our understanding of the development and treatment of food allergies. Outside of work, she tries to keep up with her husband’s busy schedule as an oncologist and enjoys spending time with her two girls, ages 1 and 2. Although her time to explore has been limited, she has really enjoyed getting familiar with Columbus.